Context: The success of prevention of mother to child transmission (PMTCT) of human immunodeficiency virus (HIV) requires the cooperation of the mother. The level of cooperation may depend on the extent of knowledge of pregnant women on HIV/acquired immunodeficiency syndrome (AIDS), its mode of transmission to the child and ways of preventing it. Aim: The aim of this study was to evaluate the knowledge and perception of mother to child transmission (MTCT) of HIV among pregnant women receiving antenatal care in a university teaching hospital in South Eastern Nigeria. SettingsandDesign : This is a cross-sectional study in a teaching hospital. Subjectsand Methods: A cross-sectional survey of 396 antenatal attendees, using a pre-tested, and interviewer administered questionnaires. StatisticalAnalysisUsed: Data were analyzed using the Epi Info statistical software and presented as percentages and tables. Results: All the respondents were aware of HIV/AIDS. The main sources of information were health workers (72.7%), radio (62.6%) and television (55.5%). Majority (94.9%) were aware that HIV can co-exist with pregnancy, but only 73.4% were aware of MTCT. Breast feeding (75.7%), transplacental (56.2%), and vaginal delivery (36.6%) were the main identified routes of transmission to the child. Some respondents (21%) however believe that cesarean section has a higher rate of vertical transmission relative to vaginal delivery. Giving the mother antiretroviral drugs (81.7%) and avoiding breast feeding (49%) were the major preventive ways identified by respondents. Some however believe that mixed feeding is one of the modes of preventing MTCT of HIV/AIDS. Conclusion: The awareness and knowledge of HIV/AIDS in the study population is high, but the knowledge and perceptions of PMTCT, is comparatively low.

Objective: Human immunodeficiency virus (HIV) infection is known to affect every organ system of the body, either directly or through opportunistic infections. Ours was a cross-sectional study to determine the prevalence of thyroid, adrenal, and gonadal dysfunction in HIV patients and to correlate these with stages of HIV infection, antiretroviral therapy, and with the associated wasting. Design: HIV patients aged ≥15 years were enrolled from July 2009 to June 2010. Each enrolled patient underwent through a thorough clinical evaluation, and questionnaire specifying the endocrine disorders were asked specifically to them. Thyroid function test (T3, T4, and TSH), serum cortisol, serum testosterone, LH, and FSH at 8:00 AM were estimated. Results: A total of 117 (90 males, 27 females) patients with a mean age of 34.10 ± 8.3 years were enrolled. TSH was elevated in 9% from reference cut-off value of 0.25-5.5 mIU/L. Only 2% were overtly hypothyroid because they had symptoms and TSH was >10 mIU/L in them. Serum cortisol could be estimated in 97 patients, of them 5 had definitive adrenal insufficiency (AI) (serum cortisol <100 nmol/l), 54 were indeterminate (100-500 nmol/l), and 38 were excluded for AI (>500 nmol/l). No patient had hypotension. Hypogonadism (serum testosterone <200 ng/dl) was found in 75.7% (28/37) males patients. However, only 27% (10/37) patients complained of impotency. The wasting was evident in 61.53% of the total patients and had positive correlation with only testosterone levels in males (P = 0.864). Conclusions: Hypothyroidism seen in HIV patients was predominantly subclinical. Since we excluded seriously ill patients from the study, sick euthyroid syndrome is unlikely as a cause for the abnormal thyroid function tests. Decreased levels of serum cortisol were found although with unclear clinical significance. HIV infected males had hypogonadism, probably hypogonadotropic.

Background: In sub-Saharan Africa, women and children are vulnerable to HIV/AIDS with about 61% of the infections occurring in women and about 90% of the pediatrics infection through Mother-to-child transmission (MTCT). Antenatal attendees in Nigeria are offered routine HIV testing and counselling on the first visit with opt-out option irrespective of the gestational age at contact. This appears commendable but, considering the national HIV prevalence of 4.6%, our large population of >140 million, the long period of seroconversion of the virus and the fact that pregnant women continue to indulge in activities like: unprotected sexual intercourse with single or multiple partners or men with multiple sexual partners or legal polygamy, cross generational sex, intercourse with sero-discordant partners that put them at risk of new infections; a single screening test on contact may not be sufficient to detect all maternal infections. Aim and Objectives: This is to perform a second HIV testing in antenatal women late in pregnancy and determined the sero-prevalence of HIV amongst those who tested negative in the first half of pregnancy. Materials and Methods: This is a prospective cross sectional study conducted among previously HIV negative pregnant women in Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi between November 2010 and February 2011. The rapid test kits: Determine, Stat Pak and Unigold were used for detection/diagnosis of HIV antibody. Semi structured questionnaire was used to collect socio-demographic data of the subjects. Descriptive analysis of the result was done using the SPSS version 16. Results: The HIV prevalence following repeat testing in late pregnancy was 3.91% (9/230). The mean HIV prevalence at antenatal booking during the study period was 20.64% (116/562). Conclusion: The study highlights the high prevalence of HIV among previously negative attendees in late pregnancy. It brings to the fore the enormity of "missed opportunity" associated with a single routine antibody rapid test for pregnant women on contact/early pregnancy. Therefore, routine repeat antenatal HIV testing and counselling in late pregnancy is strongly advocated.

Aim: Studies outside Nigeria reports that approximately 70% of human immunodeficiency virus (HIV) positives are sexually active and that their use of effective contraception is variable. Unplanned pregnancy and its complications are also common. However, no published study in Nigeria has evaluated the contraceptive use among of HIV positive women. This study aims to establish the pattern of use, knowledge and associated factors of contraception among HIV positive women. Materials and Methods: A cross-sectional questionnaire based study in a busy HIV Treatment Centre in cosmopolitan city of Lagos, Nigeria. Results: The contraceptive awareness was high at 94.6%; however, the use rate was moderate at 50.6%. Condom (52.9%) and injectable contraceptive (31.4%) were the most commonly used methods. Weight gain (2.4%) and condom slip off (2.4%) were the most common side-effect reported. Having more than 3 children (odd ratio [OR]: 2.6), being in the program for at least 3 years (OR: 2.0) and previous use of contraception (OR: 2.6) were found to be independently associated with current use of contraception. Women with less than secondary education (OR; 0.2; 0.3-0.5) and a HIV positive partner (OR: 0.4; 0.3-0.6) are less likely to use contraception. Conclusion: Contraceptive knowledge and awareness (94.6%) among this women is high, however, the use rate is low at (50.6%). Condom (52.9%) and Injectable contraceptive (31.4%) were the preferred method among women. Having 3 living children, at least a secondary education, negative partner and being in the program for at least 3 years were associated with the use of contraception.

Introduction: Antiretroviral (ARV) drugs have some associated adverse events that may jeopardize confidence in their safety and alter patient adherence to ARV therapy. Various forms of peripheral neuropathy are associated with human immunodeficiency virus (HIV) infection and its management, and these occur at various stages of HIV disease. This study is aimed at exploring the relationship between peripheral neuropathy and ARV drugs used in the management of adult HIV patients who access care in Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi, a tertiary health facility in South-East Nigeria. Materials and Methods: The study is a review of 7,280 ARV-experienced adult HIV-positive patients' medical records at NAUTH Nnewi, between July 2005 and July 2009. The adverse events electronic data base was searched, 156 patients with reported adverse events were identified and all data of 52 enrollees with peripheral neuropathies (PN) who met the inclusion criteria were reviewed. Results: Median duration of treatment with ARV drugs was 42 weeks. The prevalence of neuropathy was high among the widowed females and those greater than 40 years (P < 0.05, P < 0.01, respectively). More PN were found among subjects on offending drugs than among those on alternate drugs (P < 0.005). All subjects with co-morbidities had peripheral neuropathy, while only 27.8% of those without co-morbidity had the neuropathy (P < 0.001). Conclusion: If co-morbidities are treated in HIV patients, offending drugs such as stavudine, replaced with alternatives like Tenofovir in the management of their medical condition and socio-demographic variables considered in the selection of treatment modalities, the incidence of peripheral neuropathy among HIV patients on ARV drugs will markedly reduce.

Gangrene of the extremities: A rare manifestation of human immunodeficiency virus infection

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Mary Grace, Suma Job

Gangrene of the hands and feet is an uncommon presentation in patients with human immunodeficiency virus (HIV) infection. This results from vasculitis which is a rare but important complication of HIV infection. We present a boy on Highly Active AntiRetroviral Therapy (HAART) - combination of zidovudine, lamivudine, and nevirapine - who developed gangrene of the upper limbs as a consequence of non-specific vasculitis associated with HIV infection.